Organization
PEERSTAR ADVOCACY ALLIANCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY J NULTON PHD (PRESIDENT)
(814) 262-0025
Entity
Organization
Contact information
Practice address
399 GREEN AVE EXT, LEWISTOWN, PA 17044-3404
(814) 266-1491
(814) 266-1548
Mailing address
210 COLLEGE PARK PLZ, JOHNSTOWN, PA 15904-2833
(814) 266-1491
(814) 266-1548
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1028643170001
—
PA
05
—
1028643170002
—
PA
Enumeration date
11/04/2013
Last updated
05/09/2019
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